Leg Strength and Brain Health: What the Research Means for Perimenopause Training
When clients think about strength training, they usually think aesthetics or weight management first. What gets missed, and what I bring up constantly, is the link between lower-body strength and brain health.
A ten-year study of older female twins, published in Gerontology, found that leg power was strongly linked to how well women's cognitive function held up over time. The women with greater lower-body strength and power aged better cognitively than those without it. Strength training isn't only protecting the body, it may be protecting the brain too.
Why brain health deserves attention here
Perimenopause is a neurological transition as much as a hormonal one. I hear the same list from clients constantly:
Brain fog
Forgetfulness
Trouble concentrating
Mental fatigue
Slower processing
Mood swings
Hormonal change, broken sleep, stress, and inflammation all feed into this. Which is exactly why brain health has to be part of how we think about training during this transition, not an afterthought.
What the leg-strength research actually found
Steves and colleagues tracked physical capability against cognitive ageing in older women over ten years. Leg power predicted cognitive ageing outcomes, even after accounting for genetics and lifestyle. Put simply: stronger, more powerful legs tracked with better-preserved brain function.
A few reasons this likely holds up.
Strength training moves blood, including to your brain
Exercise drives circulation everywhere, brain included. Better blood flow means better delivery of oxygen, nutrients, hormones, and growth factors.
Strength training may also boost brain-derived neurotrophic factor (BDNF), a kind of fuel for learning, memory, and neural resilience.
Muscle is a metabolic organ
Muscle tissue plays a major role in blood sugar regulation and insulin sensitivity. Poor metabolic health tracks with higher risk of cognitive decline, inflammation, fatigue, and cardiovascular issues. Building lower-body strength supports metabolic function, and that flows through to long-term brain health, particularly as insulin sensitivity naturally shifts in this phase.
It's neurological, not just muscular
Squats, lunges, step-ups, and deadlifts all demand coordination, balance, stability, motor control, and spatial awareness. Your brain and body are in constant conversation during movement. Learning and repeating these patterns is literally training your nervous system, not just your muscles.
Why this matters more as you age
Women lose muscle mass and power with age, and that accelerates around menopause. Left unaddressed, that shows up as reduced mobility, higher fall risk, less independence, and lower confidence in your own body.
Legs carry your mobility, stability, and daily function. Maintaining strength here isn't about training harder, it's about protecting what lets you keep living the way you want to.
Why I prioritise this in programming
Perimenopause is one of the most important windows for resistance training, full stop. Done well, it supports muscle mass, metabolic health, bone density, balance, coordination, recovery capacity, and, based on this research, cognitive function.
Lower-body work earns its place here because it recruits large muscle groups and taxes both the muscular and nervous systems at once.
The exercises that actually matter
You don't need a complicated program. The foundations do the work:
Squats
Lunges
Step-ups
Romanian deadlifts
Glute bridges
Split squats
Incline or resisted walking
Progressive and consistent beats perfect, every time.
The wider picture
Brain health isn't just training. It's sleep, nutrition, stress management, recovery, movement, and connection, all working together. Strength training is one piece, but a powerful one: the body and brain don't operate separately. They're in constant conversation.
Stronger legs may mean a sharper mind, years from now. That's worth training for.
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